Organization Active NPI

White Sands Counseling Center

  • Clinical Social Worker
  • Pensacola, FL
National Provider Identifier
1952874349
Registry record updated May 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
WHITE SANDS COUNSELING CENTER
Practice address
9511 Holsberry Rd Ste B1
Pensacola, FL 32534-1320
Phone
(850) 525-2551
NPI assigned
Jan 8, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joseph R Dutra
Title
Partner
Phone
(850) 525-2551

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

9511 Holsberry Rd Ste B1
Pensacola, FL 32534-1320

Mailing address

9511 Holsberry Rd Ste B1
Pensacola, FL 32534-1320
Phone (850) 525-2551

Other identifiers 4

IdentifierTypeStateIssuer
1750722674OtherFLNPI
HU042YOtherFLMEDICARE
016112400MedicaidFL
08RBROtherFLBCBS PROVIDER

Other names 1

  • White Sands Counseling Center Other name

National Provider Directory

National Provider Directory

Locations

9511 Holsberry Rd
Ste B1
Pensacola, FL 32534
Phone (850) 525-2551

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589328000000",
    "number": "1952874349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9511 HOLSBERRY RD STE B1",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325341320",
            "telephone_number": "850-525-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9511 HOLSBERRY RD STE B1",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325341320",
            "telephone_number": "850-525-2551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE SANDS COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-08",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A",
        "authorized_official_last_name": "DUTRA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "850-525-2551"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1750722674",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "HU042Y",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016112400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER",
            "identifier": "08RBR",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "White Sands Counseling Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.